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Abstract: SA-PO339

Managing Sickle Cell Patients on Renal Replacement: The Struggle Is Real

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Guntupalli, Sri Vibhavari, Emory University School of Medicine, Atlanta, Georgia, United States
  • Keyes, Jonathan, Emory University School of Medicine, Atlanta, Georgia, United States
  • Amarapurkar, Pooja D., Emory University School of Medicine, Atlanta, Georgia, United States

Hemodialysis (HD) and peritoneal dialysis (PD) have been successfully performed in patients with sickle cell disease (SCD) and trait (SCT). However, mortality in this group remains high. Kidney transplantation is a preferred modality of renal replacement therapy (RRT) but poses great challenges. The data on longitudinal outcomes in this group various immensely. We describe our experience with sickle cell patients on various RRT.


This is a retrospective analysis of data from 2004-2021, across 4 dialysis units. 29 (3.99%) out of 726 patients with sickle cell were identified. Age, gender, race, genotype, type of RRT, RRT vintage, blood pressures, transplant referral, graft function duration, hemoglobin (Hb) and Kt/v were evaluated. Patients were grouped into SCD and SCT for comparison. Statical analysis was performed.


All 29 patients were African American with at least 3 years of pre-dialysis nephrology care. 27.5% (8) were on PD and 72.4% (21) were on HD. 51.7% (15) patients had SCD and 48.2% (14) had SC trait. Among the SCD patient, 60% (9) started dialysis between 20-40 years of age and 40% (6) between 45-70 years of age. The patients who started dialysis at a later age had a higher Hb. 85.7% (13) SCT patients started dialysis between 45-70 years of age. 66.7% (10) patients with SCD and 28.5% (4 patients) of SCT expired and only 50% (7) of all patients survived greater than 5 years after initiation of dialysis. The average intradialytic blood pressure in patients who survived < 5 years was lower when compared to those who survived > 5 years. There was no difference in Kt/V in SCD and SCT patients who survived < or > 5 years. Of the 8 PD patients 50% (4) from each group (SCD and SCT) expired in < 5 years. 20.6% (6) of all patients received transplant. 83.3% (5) of which failed at 10-year mark with 60% (3) from BK virus and 40% (2) from rejection.


The mortality in patient with SCD and SCT on RRT is extremely high. Intradialytic hypotension is a significant co-morbidity. Graft survival is also limited. A multi-disciplinary approach in required to care for these complex patients to improve outcomes. We aim to collaborate with other centres to improve access to care and data reporting in this population.